Application for Pass/Fail Or Audit

APPLICATION FOR PASS/FAIL OR AUDIT

______STUDENT I.D. NUMBER LAST NAME FIRST NAME MID.

______STREET NUMBER AND NAME CITY STATE ZIP CODE ______DAY TELEPHONE NUMBER EVENING TELEPHONE NUMBER

IF THIS IS A NEW ADDRESS/ TELEPHONE NUMBER, PLEASE CHECK HERE ______SO THAT WE MAY UPDATE YOUR RECORDS.

DIVISION: [ ] UNDERGRADUATE (01) HOME CAMPUS: [ ] NEW YORK (1) [ ] GRADUATE (02) [ ] PLEASANTVILLE (2) [ ] WHITE PLAINS (3)

SEMESTER: [ ] SPRING YEAR: ______[ ] FALL [ ] SUMMER 1 [ ] SUMMER 2 PASS/FAIL (Undergraduate only) A student with 60 credits or more and a cumulative QPA of 2.50 may take one elective course excluding core requirements and major electives per semester for a total of four courses on a Pass/Fail basis. A grade of “P” (passing) will not affect the QPA, however; a grade of “F” (failing) will be computed in the QPA. Students must notify the Office of Student Accounts and Registrar Services of their intent to take a course Pass-Fail within the first two weeks of a fifteen-week term, or the first week of a four, six or seven week session.

PLEASE NOTE: Once you have elected this option it may not be reversed.

COURSE REFERENCE COURSE NUMBER SUBJ. NUMBER

______

INSTRUCTOR’S NAME: ______

I elect the PASS/FAIL option in the above course in accordance with the University policy.

______STUDENT’S SIGNATURE DATE AUDIT Students electing to register on an AUDIT basis pay full tuition and will receive no grade or credit for the course. Graduate students may not AUDIT a degree required course.

PLEASE NOTE: Once you have elected this option it may not be reversed.

COURSE REFERENCE COURSE NUMBER SUBJ. NUMBER

______

INSTRUCTOR’S NAME: ______

I elect the AUDIT option in the above course in accordance with the University policy.

______STUDENT’S SIGNATURE DATE NOTE: These options are not available to non-matriculated or visiting students.